Cervical cancer continues to be an important public health problem in Latin America. Few studies have been conducted in Central America, such as in Panama. The overall goal of the proposed study is to determine HPV and cervical cancer knowledge, attitudes, beliefs, and behaviors as well as community and environmental factors related to Pap smear screening and HPV vaccine acceptability among men and women residing in Panama. The currently proposed FIRCA application will collect information needed to develop and implement prevention and immunization strategies in both men and women living in the San Miguelito district of Panama City with the highest reported prevalence of HPV. Previous studies and preliminary data suggest that the role men play in cervical cancer and HPV transmission, and also in the prevention of the two is often ignored. A community-based participatory process and Social Cognitive Theory will be used to conduct the proposed study. Building-on the infrastructure of the parent grant we propose to develop a community-based advisory board (CAB) comprised of key community leaders in the district of San Miguelito district with highest prevalence of HPV to participate in planning, study design, and instrument development; develop and implement a community-based questionnaire among a random household sample using cluster analysis techniques; assess knowledge of cervical cancer and HPV, and screening awareness and attitudes among men and women, current screening and sexual behaviors among men and women, HPV vaccine acceptability for men, women, and their children; and, understand the social cognitive factors associated with knowledge, attitudes, beliefs, and behaviors toward cervical cancer screening and vaccine acceptability strategies. Rather than focus on structural factors (e.g., access, transportation, cost), we hypothesize that social networks (e.g., men and other women) and norms are important factors that influence screening and sexual behavior among men and women. We also hypothesize that men and women in Panama generally lack knowledge and awareness on HPV and its association with cervical cancer and that men play an important role in women's screening seeking behavior. The proposed study brings together an international multidisciplinary group of researchers to study socio- cultural and behavioral factors associated with cervical cancer prevention and vaccine acceptability. The proposed study will fill this gap by building-on previous experience, current studies, and applying social and behavioral principles in the study of knowledge, attitudes, beliefs and behaviors associated to cervical cancer and HPV control. [unreadable] [unreadable] [unreadable]